Intrauterine Insemination (IUI)
The use of medication to trigger the development and release of an egg or eggs from the follicles in the ovaries is called ovulation induction. Fertility medications allow women to safely produce multiple eggs during a single cycle. Production of more than one egg increases the chance for a successful cycle by increasing the odds of healthy fertilization and implantation. These medications are usually used in conjunction with other treatments such as intrauterine insemination (IUI).
Intrauterine Insemination (IUI) is a procedure in which sperm that has been washed and prepared is inserted into the woman’s uterus through a catheter. This procedure allows the sperm to pass directly into the fallopian tubes where fertilization normally occurs.
Performed at the time of ovulation, IUI increases the likelihood of fertilization and pregnancy. Vaginal ultrasound and/or a urine ovulation detection kit are used to ensure that the procedure is conducted at the right time. IUI is recommended for patients who have been diagnosed with:
- Abnormal or inhospitable cervical mucus
- Unexplained infertility
- Male factor infertility
Donor Intrauterine Insemination (DIUI)
Couples or individuals choose which sperm donor to use. Information about a donor's physical characteristics, race, ethnic background, and general health are usually provided by the Andrology department.
As with IUI fertility medications may be given prior to treatment. The DI procedure involves inseminating the woman as close to the time of ovulation as possible. Depending on the treatment and the woman’s history, she may monitor her ovulatory cycles by testing her urine for an LH surge, or the doctor might recommend a medication (hCG) to induce release of the egg(s).
In Vitro Fertilisation (IVF) & Intracytoplasmic Sperm Injection (ICSI)
In vitro fertilization (IVF) is a highly successful assisted reproductive technology. There are four basic steps in an IVF treatment cycle:
Ovulation Induction
A woman begins taking fertility medications to encourage the development of eggs within the ovaries. These medications stimulate the follicles to produce more than one egg in a cycle.
Egg Retrieval
Egg retrieval is a minor surgical procedure that can be performed on an outpatient basis at IVFWales. It typically takes about an hour and requires sedation.
Fertilization and Embryo Development
The retrieved eggs are placed in a petri dish with a special solution for 2 to 3 hours. During this time, the male partner provides a semen sample. The sample is delivered to the lab where it undergoes a process referred to as “washing.” The washed sperm are incubated and placed in the petri dish with the eggs (IVF). If there are problems with the sperm sample then individual sperm can be injected into the egg to bypass any barriers of fertilisation (ICSI). After 18 hours, the eggs are examined. If fertilization occurs, then one to three of the resulting embryos are selected for transfer back to the woman.
Embryo Transfer
Embryo transfer is a simple procedure that does not require anesthesia. The selected embryos are inserted into a thin tube and guided toward the woman’s uterus, where it is hoped they will continue their natural development. Transfer typically takes place two or three days after egg retrieval, or five to six days after retrieval in the case of blastocyst transfer. Rest and recovery are recommended for 24 to 48 hours. Through ongoing research, IVFWales Embryologists have developed methods for identifying the highest quality embryos – those most likely to implant and lead to a pregnancy. Such embryos are rated on the number of cells and the quality of cell growth.
Other Advanced Fertility Treatments
EmbryoFreezing Embryo freezing permits high quality embryos that are not immediately used for IVF to be frozen for the couple’s later use. Approximately half of all frozen embryos remain viable after thawing and can be successfully used in IVF treatment. If the frozen embryos are no longer needed, they can be donated to research, donated to other infertile women or discarded.
EggFreezing
IVFWales are please to be the first clinic in the UK to offer egg and embryo freezing with a new technique called 'Vitrification'. With the technique we are enabled to freeze eggs for women with cancer whose cancer treatment will render them infertile. The technique also offers women an opportunity of delaying childbirth for social reasons. Please call the clinic for details.
Assisted Hatching
There is a phase in embryo development during which the embryo must be released, or ‘hatched’ from its hard outer covering. Infertility results when natural hatching from the shell fails to occur. Assisted hatching can be performed using lasers, mechanical techniques or chemicals to help this process.
Blastocyst Transfer
In a typical IVF cycle, fertilized eggs are returned to the uterus after two to three days of maturation. In the past, in vitro culture media could not sustain embryo growth beyond this time. Today it is possible for embryos to mature in vitro for up to five days, at which point they develop into blastocysts. Only the healthiest eggs will make it to the blastocyst stage. Blastocyst transfer is not appropriate for all patients. Talk to your IVFWales team member about whether it is right for you.
